Individual
MS. MARY JANE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
6801 HIGH GROVE BLVD, BURR RIDGE, IL 60527-7585
(630) 734-4588
(630) 920-2453
Mailing address
6801 HIGH GROVE BLVD, BURR RIDGE, IL 60527-7585
(630) 734-4588
(630) 920-2453
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057001875
IL
Other
Enumeration date
11/13/2008
Last updated
11/13/2008
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